title: Long-term survival in Waldenstrom macroglobulinemia: 10-year follow-up of Southwest Oncology Group-directed intergroup trial S9003.
abstract: The survival of patients with Waldenstrom macroglobulinemia (WM) varies enormously. The development of prognostic models in WM has been fraught by limited follow-up in current studies. Here, we update the outcome of a prospective WM trial with a median follow-up of 10 years for live patients. Of the 59 previously untreated patients who initially were observed, only 12 patients (21%) required therapy at a median follow-up of 100 months. Multivariate analysis among the 183 patients requiring therapy reaffirmed age 70 years or greater, previous nonprotocol therapy, and beta-2 microglobulin (B2M) of 3 mg/dL or greater as prognostic factors. Importantly, increased serum lactate dehydrogenase (LDH) was identified as an additional independent variable, which improved risk assessment beyond the recent WM international prognostic scoring system (ISSWM). By using age, previous therapy, B2M, and LDH, we identified 3 risk groups with 8-year survival estimates of 55%, 33%, and 5% (P < .001). These data provide novel insights into factors predicting long-term outcome in WM. This trial has been registered with www.cancer.gov under ID 4852904.
authors.affiliation: Section of Hematology and Yale Cancer Center, Yale University, New Haven, CT 06510, USA. madhav.dhodapkar@yale.edu
authors.forename: Madhav V
authors.initials: MV
authors.lastname: Dhodapkar
authors.forename: Antje
authors.initials: A
authors.lastname: Hoering
authors.forename: Morie A
authors.initials: MA
authors.lastname: Gertz
authors.forename: Saul
authors.initials: S
authors.lastname: Rivkin
authors.forename: Jackie
authors.initials: J
authors.lastname: Szymonifka
authors.forename: John
authors.initials: J
authors.lastname: Crowley
authors.forename: Bart
authors.initials: B
authors.lastname: Barlogie
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008495:Medical Oncology; D012955:Societies, Medical; D015206:Southwestern United States; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D008258:Waldenstrom Macroglobulinemia / Q000401:mortality*